Published on 24 July 2022

    Sometimes medication doesn’t work. The problem could be antimicrobial resistance – here’s what you need to know.

    Ever taken medication for an infection only to find that it doesn’t work? It could be because of a phenomenon called antimicrobial resistance (or AMR for short).

    So why exactly does AMR happen? With infections caused by bacteria, viruses, fungi, and some parasites – a group of organisms known as microbes – antimicrobial medication can help to kill them or stop their growth. These medications are used to prevent and treat infections in humans, animals and plants.

    But sometimes, these microbes develop the ability to survive exposure to this medication, and instead grow and multiply. This happens when, over time, the microbe that causes the infection develops a gene mutation or acquires genes resistant to the antimicrobial medication. As a result, the infections become harder or impossible to treat: never good for anyone!

    Studies have also shown that the more we use antimicrobials, the higher the rates of antimicrobial resistance (AMR). This poses a significant threat to global human health and strain on healthcare infrastructure.

    Myths and facts

    Ms Fathima Rofina and Ms Chen Hui Hiong, who are Senior Pharmacist and Senior Clinical Pharmacist respectively at the National University Hospital, noted the three biggest misconceptions about the use of antimicrobials: 

    Myth 1: Only people who use antibiotics regularly are at risk of antibiotic resistance.

    As antimicrobial resistance can be transferred between organisms and humans, everyone is at risk of getting a resistant infection. 

    Myth 2: If I catch a cold or COVID-19, I can get faster with antibiotics. 

    This is not true. Most of the time, the common cold is caused by viruses. Antibiotics only kill bacteria, not viruses (including coronaviruses like COVID-19). Thus, antibiotics will not help you feel better or get well faster, but may instead cause undesirable side effects such as diarrhoea or abdominal pain. 

    Myth 3: If one antibiotic does not work, there will be another that does.

    Unfortunately, there is a growing number of multidrug-resistant strains of bacteria that are resistant to many antibiotics. In some cases, this leaves no treatment available – a scary thought! While new drugs are certainly being developed, the pace of development has slowed down in recent decades. 

    A global problem for all of us

    Antimicrobial resistance is a global problem, so everyone has a role to play in the fight against AMR – from industry players and policymakers to the general public. AMR is accelerated by human activities such as the overuse and misuse of drugs, the spread of infections, and the contamination of the environment. 

    The misuse or overuse of antimicrobials in particular include: asking for antibiotics from doctors when they are not needed, not taking antibiotics as per your doctor’s instructions, taking antibiotics that have been prescribed for someone else, and taking leftover antibiotics. Taking antibiotics when they are unnecessary or not prescribed can be particularly harmful as they may not be suited to the specific infection you have, which increases the chances of AMR. Stinging on doses or not taking antibiotics as prescribed can cause similar effects. 

    The results can be catastrophic as AMR may mean that your illness becomes more severe and even untreatable. If you remain unwell after completing your course of medication, you should inform your doctor – if required, they will take a sample from the site of infection to do a lab test. Follow your doctor’s advice accordingly. 

    How to fight antimicrobial resistance 

    In the meantime and on an individual level, Ms Rofina and Ms Chen advise following these best practices:

    1. Do not request antibiotics when not prescribed by your doctor.

    2. If your doctor prescribes you antibiotics, follow his or her advice (e.g. keeping to prescribed doses, completing the entire course of medication). Do not share your medication with friends, relatives or acquaintances, or keep any leftovers for future use. 

    3. Ensure your vaccinations are up-to-date.

    4. Observe hand hygiene – wash your hands regularly with soap and water. 

    5. Stay home when you are unwell. Wear a mask as necessary when going out. 

    AMR is an on-going challenge. But judicious prescription and use of antimicrobials coupled with infection prevention and good hygiene are key to reducing the risk of spread of antimicrobial-resistant organisms.

    In consultation with Ms Fathima Rofina, Senior Pharmacist, and Ms Chen Hui Hiong, Senior Clinical Pharmacist, Pharmacy, NUH.

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